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Texas Statutes (Last Updated: January 4, 2014) |
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INSURANCE CODE |
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Title 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES |
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Subtitle D. PROVIDER PLANS |
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Chapter 1301. PREFERRED PROVIDER BENEFIT PLANS |
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Subchapter D. RELATIONS BETWEEN INSUREDS AND PREFERRED PROVIDERS |
Sec. 1301.152. CONTINUING CARE IN GENERAL
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(a) An insurer shall establish reasonable procedures for ensuring a transition of insureds to physicians or health care providers and for continuity of treatment.
(b) An insurer shall:
(1) provide, subject to Section 1301.160, reasonable advance notice to an insured of the impending termination of the participation in the plan of a physician or health care provider who is currently treating the insured; and
(2) in the event of termination of a preferred provider's participation in the plan, make available to the insured a current listing of preferred providers.
(c) A contract between an insurer and a physician or health care provider must include a procedure for resolving disputes regarding the necessity for continued treatment by the physician or provider.